【摘要】 目的研究肠黏膜通透性改变与肝硬化患者分级及预后的关系。方法选取2019年9月至2020年10月上饶市人民医院收治的60例肝硬化患者作为研究对象,将其作为肝硬化组,采用Child-Pugh评分将肝硬化组分为A组(25例)、B组(29例)和C组(6例)。另选取上饶市人民医院同期的60例体检正常者作为健康组。比较肝硬化组、健康组受检者的肠黏膜通透性指标以及肝硬化组患者的预后情况。结果肝硬化组的血清二胺氧化酶(DAO)、D-乳酸、内毒素(EXT)水平高于健康组,差异有统计学意义(P<0.05);C组的血清DAO、D-乳酸、EXT水平、终末期肝病模型(MELD)评分高于A组和B组,差异有统计学意义(P<0.05);B组患者血清DAO、D-乳酸、EXT水平、MELD评分高于A组,差异有统计学意义(P<0.05)。血清DAO、D-乳酸、EXT与MELD均呈正相关(P<0.05)。结论肠黏膜通透性改变与肝硬化患者分级及预后均呈正相关,临床可考虑通过检测肝硬化患者血清DAO、D-乳酸、EXT水平指导早期风险评估与防治。更多还原

【Abstract】 Objective To study the relationship between the changes in intestinal mucosal permeability and the classification and prognosis of patients with liver cirrhosis. Methods A total of 60 patients with liver cirrhosis admitted to Shangrao City People′s Hospital from September 2019 to October 2020 were selected as the research objects and divided into cirrhosis group, and they were divided into group A(25 cases), group B(29 cases) and group C(6 cases) by Child-Pugh score. Another 60 cases of normal physical examination in Shangrao People′ s Hospital during the same period were selected as health group. The intestinal mucosal permeability indexes of the subjects in the cirrhosis group and the healthy group were compared, and the prognosis of the patients in the cirrhosis group were compared. Results The levels of serum diamine oxidase(DAO), D-lactic acid, and endotoxin(EXT) in the cirrhosis group were higher than those in the healthy group, and the differences were statistically significant(P<0.05). The serum levels of DAO, D-lactic acid, EXT and model for end-stage liver disease(MELD) score in group C were higher than those of group A and group B, and the differences were statistically significant(P<0.05). The levels of serum DAO, D-lactic acid, EXT and MELD in group B were higher than those of group A, and the differences were statistically significant(P<0.05). D-lactic acid, EXT and MELD were all positively correlated with MELD(P<0.05). Conclusion Changes in intestinal mucosal permeability are positively correlated with the classification and prognosis of patients with liver cirrhosis. Clinically,detection of serum DAO, D-lactic acid and EXT levels in patients with liver cirrhosis can be considered to guide early risk assessment and prevention.更多还原